CEREC GUIDE 2 SOFTWARE
With complete healing of the surgical site a 3D CBCT image was acquired and using the measuring tool in the Galaxis software the bone volume was measured and an appropriate implant size was planned. After healing was complete, the treatment plan was to do a CEREC Guide 2 placement of a Nobel Parallel CC 3.75 mm x 10 mm implant with a Sirona Ti-Base Emax screw down crown. The site was then left to heal for a period of five to six months. The advantage of this technique is that it forms a mucopolysaccharide fibroblastic barrier, and there isn’t a need to attain primary closure. The membranes were secured with cross and independent sutures and were removed after three to four weeks along with the external Cytoplast membrane. The treatment plan was to do an extraction and simultaneous bone graft using 0.5 cc Symbios autogenous bone graft with a dual membrane technique using a Geistich Bio-Guide absorbable collagen and a Cytoplast non-absorbable membrane on top. Our patient Bonnie had a non-restorable #24 and requested an implant-supported restoration as a replacement. Let’s look at an example of the digital workflow. See Figure 2 for the CEREC Guide 2 digital workflow.Ĭerec Guide – 2 digital workflow. It allows you to remain in a digital environment without using conventional models and provides you with two options for in-office manufacturing: milling of the surgical stent and/orģD printing. Having the software design the surgical guide at a preset drill length to ensure accurate placement of the implant in its virtually desired position.ĭentsplySirona’s CEREC guide 2 has several distinct advantages when it comes to theirĭigital workflow.The ability to virtually place an implant in its ideal location while viewing the above structures.The ability to measure locations and relative distances of anatomic structures.
The ability to manipulate this model 3 dimensionally over a variety of different planes.The ability to combine the patient/model scan and 3D CBCT showing accurate tissue and tooth anatomy superimposed over the 3D bone volume.The ability to take a 3D CBCT showing the bone volume and anatomic structures.The ability to scan patient/model and digitally ‘wax-up’ the proposed prosthetic position of the final implant restoration.When looking at computer-aided planning, the main advantage over traditional analog techniques are: As a result, computer-aided guided surgery has become a common standard of care for both novice and experienced surgeons alike. When compared to non-guided implant surgery, that degree of error was far less even for an experienced surgeon. Variations were found to be clinically significant and measurable in most studies involving computer-aided guided surgery. Therefore, accurate pre-surgical planning, considering anatomical limitations, and prosthetic demands is essential to ensure a predictable treatment. 1,2Ĭomputer-aided guided implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure however, linear and angular deviations are to be expected. When looking at a review of literature reporting deviations in preoperative implant planning and postoperative implant locations, the comparison of implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation, 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of 2.42° (SD, 1.02) ( Fig. The increase in accuracy that is achieved from guided surgery has also been found to have a degree of error associated with it. This article will explore the digital work that is found with CEREC guide 2, from digital wax up to manufacturing to surgery to placement of the final screw down restoration. Surgical procedures then become less invasive in nature resulting in less patient morbidity and fewer complications. Technology has advanced rapidly and the level of integration now available allows us to fabricate surgical stents and produce them chairside with in-house milling or 3D printing with the same degree of accuracy as 3rd party manufactures. The key to this planning comes from knowing the final gingival zenith position in our gingivally drive treatment plan. From that position, we can then plan and manufacture the surgical guide to place the implant to support that prosthetic outcome. By using the latest in intraoral imaging, we can now virtualize the ideal gingival zenith position and appearance of the implant restoration. Our current standard of care is three-dimensional placement of implants being gingivally driven. From the start, implant dentistry was considered to be surgically driven. The evolution of implant treatment planning has changed over the course of history.
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